Comparing chronic interpersonal and noninterpersonal stress domains as predictors of depression recurrence in emerging adults

Abstract

Understanding how persistent interpersonal difficulties distinctly affect the course of major depressive disorder (MDD) during emerging adulthood is critical, given that early experiences impact future coping resources and functioning. Research on stress and MDD has mostly concentrated on stressful life events, while chronic stress largely has not been explored. The present study examined interpersonal (intimate relationship, close friendships, social life, family relationships) and noninterpersonal (academic, work, financial, personal health, and family members’ health) domains of chronic stress as time-varying predictors of depressive recurrence in emerging adults. Baseline assessments identified previously depressed emerging adults (N=119), who subsequently completed 6-month, 12-month and 18-month follow-up interviews to determine chronic stress experiences and onset of new major depressive episodes. Survival analyses indicated that time-varying total chronic stress and chronic interpersonal stress predicted higher risk for depression recurrence; however, chronic noninterpersonal stress was not associated with recurrence. Intimate relationship stress, close friendship stress, family relationship stress, personal health, and family members’ health independently predicted MDD recurrence, over and above well-established depression risk factors of dysfunctional cognitions and personality disorder symptoms. Evidence that interpersonal stress could have substantial impact on course of depression is consistent with theories of emerging adulthood, a time when young people are individuating from the family and experiencing significant social transition.

Depressive symptom composites associated with cortisol stress reactivity in adolescents

“…Further, youth who experienced stressful life events were more likely to develop MDD (Grant et al, 2004). Interpersonal stressors predicted first onsets and recurrences of MDD (Sheets and Craighead, 2014), and the HPA axis appeared to play a role in this increased vulnerability (Colich et al, 2015; Rao et al, 2008). For example, cortisol reactivity to psychosocial stressors predicted depressive symptom trajectories in formerly depressed emerging adults (Morris et al, 2012) and development of MDD in girls (Colich et al, 2015).…”

Trajectories of Functioning Into Emerging Adulthood Following Treatment for Adolescent Depression

“…Functional impairment may be particularly disruptive during the transition from adolescence to adulthood, which is a critical period for attaining key developmental milestones including attending college, obtaining employment, and learning to live independently(3). During this time questions of identity become paramount, catalyzed by the onset of puberty(4), increasing complexity of parental(5), peer and romantic relationships(6, 7), and rising expectations of independent functioning(8). Viewed through this lens, transition from adolescence to young adulthood is a demanding developmental stage for even the well-adjusted adolescent.…”

Predictors of first-episode unipolar major depression in individuals with and without sub-threshold depressive symptoms: A prospective, population-based study

“…Second, the NESARC had limited assessment of social and interpersonal stressors, which have repeatedly been implicated in the development, maintenance, and recurrence of MDD (e.g. (Asselmann et al, 2015; Sheets and Craighead, 2014)). Third, the definition of sub-threshold depression emphasizes symptom count over duration.…”